Description:

Zinacef 750mg (cefuroxime sodium by Sandoz) is a second-generation cephalosporin antibiotic for parenteral administration. It is used to treat a wide range of bacterial infections caused by susceptible organisms, including respiratory tract infections (e.g., pneumonia, bronchitis), urinary tract infections (including pyelonephritis), skin and soft tissue infections, bone and joint infections, intra-abdominal infections, gonorrhoea, and meningitis. It is also used for surgical prophylaxis (e.g., orthopaedic, abdominal, gynaecological procedures). Cefuroxime is bactericidal, inhibiting bacterial cell wall synthesis. In Ghana (Accra), Zinacef 750mg is a commonly prescribed hospital antibiotic available in pharmacies and used for moderate to severe infections requiring IV/IM therapy.

Prescription:

Prescription-only (requires a doctor’s prescription in Ghana; dispensed by pharmacies or administered in hospitals/clinics with Rx; typically initiated by physicians or surgeons; not OTC due to need for bacterial culture/sensitivity guidance, monitoring, and IV/IM route).

Therapeutic Category:

Second-Generation Cephalosporin Antibiotic (Parenteral beta-lactam antibacterial).

Active Ingredients/Composition:

• Active ingredient: Cefuroxime sodium – 750 mg per vial (powder for reconstitution). Other ingredients: None additional (sterile powder). Reconstituted with sterile water for injection or compatible IV fluid to produce a clear solution (approximately 225 mg/ml for IM or higher for IV).

Vitamins: None.

Minerals: None.

Variant:

• Zinacef 750mg powder for solution for injection or infusion (standard 750mg vial). Related variants: Zinacef 250mg vial (lower dose), Zinacef 1.5g vial (higher dose for severe infections). The 750mg vial is the most common adult dose strength for IV/IM use.

Consume Type:

Injectable – Intravenous (IV) infusion or slow IV bolus, or Intramuscular (IM) injection (administered only by healthcare professionals; powder reconstituted before use).

Directions/Usage: Administered only in clinical settings.

• Adults: Typical dose 750 mg IV/IM every 8 hours (1.5 g every 8 hours for severe infections like pneumonia or meningitis).
• Surgical prophylaxis: 1.5 g IV at induction of anaesthesia, then 750 mg every 8 hours for 24 hours (or longer in high-risk cases).
• Reconstitution: Add 3 ml sterile water for injection to 750mg vial (yields ~3.4 ml solution for IM or further dilution for IV).
• IV bolus: Inject slowly over 3–5 minutes.
• IV infusion: Dilute further in 50–100 ml compatible fluid (0.9% NaCl or 5% dextrose) and infuse over 30–60 minutes.
• IM: Deep intramuscular injection (alternate sites).
• Renal impairment: Reduce dose/frequency (e.g., 750 mg every 12 hours if CrCl 10–20 mL/min).
• Duration: 5–14 days depending on infection; complete full course.

Common Side Effects: Common:

• Injection site reactions (pain, phlebitis, swelling).
• Gastrointestinal: Nausea, diarrhoea, abdominal pain.
• Rash, pruritus.
• Transient liver enzyme elevation. Rare/serious (seek immediate help): Severe allergic reactions (anaphylaxis, angioedema), Clostridium difficile-associated diarrhoea, seizures (high doses or renal impairment), or haemolytic anaemia.

Package Type:

Glass vial of powder (750mg cefuroxime per vial; single vial or pack of 10 vials; labelled carton with reconstitution instructions and warnings).

Storage Advice: Store unopened vials at room temperature (below 25–30°C) in original packaging, protected from light. Do not freeze. Reconstituted solution: Use immediately or refrigerate (2–8°C) for up to 24 hours (check label). Diluted infusion: Use within 24 hours refrigerated or 4–8 hours at room temperature.

Safety Advice:

• Administered only under medical supervision (risk of anaphylaxis in penicillin/cephalosporin-allergic patients – take careful history).
• Contraindicated in hypersensitivity to cefuroxime, other cephalosporins, or severe beta-lactam allergy.
• Caution in renal impairment (dose adjustment required), history of GI disease (C. difficile risk), or concurrent nephrotoxic drugs.
• Monitor for superinfections (e.g., C. difficile diarrhoea) and renal function.
• If rash, fever, severe diarrhoea, or breathing difficulty occurs, stop use and seek urgent care.
• Keep out of reach of children (overdose risk).

Product Substitutes: Similar cefuroxime 750mg IV/IM injections in Ghana include:

• Generic cefuroxime sodium 750mg powder for injection (various importers).
• Zinacef (original GSK brand if stocked).
• Ceftin or other local generics. Alternatives: Ceftriaxone 1g/2g IV, cefotaxime, or ceftazidime (third-generation cephalosporins) for broader coverage. Consult doctor/pharmacist in Accra (e.g., hospital pharmacy) for alternatives.

Manufacturer/Marketer:

Sandoz (a Novartis division; Sandoz Ltd. is the marketing authorisation holder for Zinacef in many markets, including Europe and export regions). Marketed/distributed in Ghana by local importers/pharmacies (widely stocked as imported product).

Country of Origin:

Slovenia (manufactured by Sandoz Pharmaceuticals d.d., Novo mesto, Slovenia; imported to Ghana and available in local pharmacies/hospitals).